Form 465 (3)Supplemental Independent
Expenditure Report
(Government Code Section 84203.5)
SEE INSTRUCTIONS ON REVERSE
Type or print in ink.
Amounts may be rounded to
whole dollars.
❑ Amendment (Explain Below)
1. Committee/Filer Information I.D. NUMBER (If recipient committee)
COMMITTEE/FILER'S NAME
ADDRESS (NO P.O. BOX)
- I% I
CITY
Cjilf r' C
STATE ZIP CODE AREA
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Report covers period Date Stamp CALIFORNIA
from J 14 e t o I • •
through C Page of
Date of election if applicable: OCT -4
PAS 4 16 For Official Use Only
(Month, Day, Year)
D
Treasurer (If recipient committee)
NAME OF TREASURER
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS UrIIUIIML. rr /C-MV ILMUUR000
N\i
2. Name of Candidate or Measure Supported or Opposed CHECK ONE
NAME OF CANDIDATE ,fO-F-FICE SOUGHT OR HELD AND DISTRICT, IF APPLICABLE SUPPORT OPPOSE
1 t ,n, c_A 1.F ip 1 Vt r--. m' :A J i Inc. 'Z C-11,1 Oil "Aot , I
NAME OF BALLOT MEASURE I BALLOT NO./LETTER I JOASDICTION SUPPORT OPPOSE
3. Independent Expenditures Made Attach additional information on appropriately labeled continuation sheets. CUMULATIVE TO DATE
UAIt
NAME AND ADDRESS OF PAYEE
DESCRIPTION OF EXPENDITURE
AMOUNT
li LCIV U/1R TC^R
JAN. 1 - DEC. 31
^
l3 VIA.C A I Sri
7 A--
FIPIPC Form 465 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)
SUPPLEMENTAL INDEPENDENT EXPENDITURE
Supplemental Independent Type or print in ink.
Amounts may be rounded Report covers period
Expenditure Report to whole dollars.
from
SEE INSTRUCTIONS ON REVERSE through Page of
NAME OF FILER I.D. NUMBER (If recipient corn.)
4. Summary ~ ~ a ~
1. Total independent expenditures of $100 or more made this period. (Part 3.) $
2. Total independent expenditures under $100 made this period. (Not itemized.) $
3. Total independent expenditures made this period (Add Lines 1 + 2.) TOTAL $ 6o S G
5. Filing Officers Enter the name and address of each filing officer with whom the filer's most recent campaign statements (Form 450, 460 or 461) have been filed.
1) NAME OF FILING OFFICER 3) NAME OF FILING OFFICER
(NO. AND STREET) ADDRESS (NO. AND STREET)
a013 d ' r~W OiIVJ. -~2e
CITY STATE ZIP DE CITY STATE ZIP CODE
2) NAME OF FILING QOPFICER 4) NAME OF FILING OFFICER
ADDRESS (NO. AND STREET)
ADDRESS (NO. AND STREET)
CITY STATE ZIP CODE CITY STATE ZIP CODE
6. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true and correc
Executed on 6 G f Ll - y 0 gy
DATE I URE O R, TREASURER OR ASSISTANT TREASURER
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 465 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)